title: Liver dysfunction in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  We aimed to define the clinical features of liver dysfunction in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  The frequency and causes of liver dysfunction were examined in 206 patients with SLE.
  
  
  RESULTS
  Liver dysfunction was evident in 123 (59.7%) of the 206 patients. Liver dysfunction in patients with SLE can be drug-induced (30.9%) or caused by SLE itself (28.5%), fatty liver (17.9%), autoimmune hepatitis (AIH) (4.9%), primary biliary cirrhosis (2.4%), cholangitis (1.6%), alcohol (1.6%) or viral hepatitis (0.8%), and it tends to be mild except when caused by AIH. Values for aminotransferase were significantly increased when AIH was the cause, whereas alkaline phosphatase (ALP) and γ-glutamyl transpeptidase (γ-GTP) were significantly increased when AIH or drugs were the cause. The liver was already dysfunctional at the time of SLE onset in 56 (45.5%) of 123 patients with liver dysfunction. Neurological involvement was more common among patients with than without liver dysfunction, whereas SLE activity and prognosis did not significantly differ between the two groups.
  
  
  CONCLUSIONS
  Liver dysfunction in the presence of SLE can be caused by many factors, but when extant at the time of SLE onset, either SLE itself or drugs can be the cause. Autoimmune hepatitis should be considered when liver dysfunction is relatively severe.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan. junior@fmu.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Abe
authors.forename: Rie
authors.initials: R
authors.lastname: Saito
authors.forename: Haruyo
authors.initials: H
authors.lastname: Iwadate
authors.forename: Ken
authors.initials: K
authors.lastname: Okai
authors.forename: Fumiko
authors.initials: F
authors.lastname: Katsushima
authors.forename: Kyoko
authors.initials: K
authors.lastname: Monoe
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanno
authors.forename: Hironobu
authors.initials: H
authors.lastname: Saito
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents